CancerTesting
 

The threads on prostate cancer and a couple individual posts include advice to be tested frequently. But, what to do if you can't be tested?

After my last colonoscopy the surgeon told me that was my last one. I was now too old for testing. Then my primary care provider, an internal medicine MD, told me neither PSA nor manual prostate testing was appropriate any longer. In fact, for elders, apparently no colon or prostate cancer screening is the new standard.

Is that your experience?

Just saw my urologist and even though he will still be checking my PSA, they wouldn't likely do anything at my age if cancer developed. Seems that 80% of Prostrate cancer is slow growing and not life threatening. Something that my father-in-law would have liked to know before his prostrate surgery which led to a incontinence issue. I'm a little fuzzy about the more aggressive form and what they do in that case.

Funny thought on who is considered elderly. At my provider, a pregnant woman in her mid to late 30's is considered elderly. So HawkOwl, what is your apx age? I'm just over 50 and still get an annual PSA and a digital exam (PSA comes first...). So I guess I have this ambiguity to look forward to then?

I'm told my next colonoscopy, due soon, will be my last. I'll be 73. I've not been told, but from what I've read, the same might be true for prostate testing.

My insurance supplement a la Medicare seems to suggest that prostate cancer screening is no longer recommended nor paid for. I am close to 74, but I read where it is no longer considered appropriate for anyone. Ditto with colonoscopy at later ages.

Yup, not every organization agrees with this new position. You are correct, it is not age based.

Curious, is the thinking here that if you have made it thus far your chances of developing either disease are dropping fast? I've got twenty years till this point anyway...

This should be a matter of individual choice. The patient should read the pros and cons, the risks associated with each option, and decide for him/herself the best course of action. Your doctor is your paid consultant and employee (follow the cash flow), not your boss. Likewise, the last time I checked the most famous short-and-sweet speech ever given, this is a "government of the people, by the people, and for the people," so it really should not be up to Uncle Sam to decide what screening or treatment is appropriate for you.

Irrespective of what one decides regarding screening and treatment, there is no substitute for prevention, and we do now know enough to make conservative, sound dietary and lifestyle recommendations which significantly reduce the risks and progression rates of various diseases. Bad things will always happen to good people who do every thing right, but we can manipulate the odds in both directions.

No.

I ask myself a very simple question: how bad would I feel if I missed an early colon cancer in this individual? It makes no sense to deny someone who is robust, playing tennis 5 times a week, and on fewer meds than I am a colonoscopy just because they have the "wrong" number after their age.

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More like the risk of harm caused by treatment could be greater than harm caused by potential disease. These are screening tests, not diagnostic tests where there is suspicion of disease or symptoms are present.

Don't have routine PSA testing.
Latest Take is-It won't prolong your life-but it MIGHT earn you surgery-incontinence impotence pain cost
so avoid PSA

Test results themselves don't prolong or shorten anyone's life. It's the actions that are taken in response to test results. Test all you want, but consider very carefully what you do in response to those results.

To me the age related testing cut off is misapplication of statistics. Based on what I've read I do not quarrel with the conclusion that these tests do not extend life, nor improve it's quality for the population as a whole. That is a whole different thing than impact on an individual in the group.

Depending on factors such as genetics, life style and current health status a 75 year old can expect to live into their mid-90s. That is a lot of time to allow cancers to grow that could have been easily taken care of if caught early.

So the industry and population as a whole saves money at the cost of individuals.

To me a better answer is better provider and patient education so better,more realistic decisions can be made.

71 years here.

My doctor's office said it was up to me to be tested or not.

I chose the PSA.

I think what's driving the new colonoscopy standards is the high cost & insurance not wanting to deal with it. I wished they left the decision of when to stop testing up to the doctor and patient. My "adopted" dad (a close neighbor of mine) would've/should've been tested but was told he was "told old." He died a year ago of colon cancer.

75yo seems to be the age for no colon cancer testing - at least insurance paid testing.

I can recall at least 10 folks on this forum who have had their lives saved (or claim to) by PSA testing for prostate cancer. Epidemiology means nothing to an individual with cancer.

That's not been my experience. I've not heard of any claims being rejected due to age alone.

I think everyone realizes the Feds will impose rigid guidelines as they consolidate their power, but until they do, I'll try to do what's right for the individual.

We've had threads in the past where it has been noted that testosterone production falls off with age. A rather high percentage of deadly prostate cancers are testosterone-dependent for growth, particularly in their early years. Thus, older males have a substantially reduced risk. Coupling that with the likelihood of bad outcomes from unnecessary treatment decisions that would likely follow suspicious results from a (dubious) PSA test, and guidelines that make it more difficult/expensive to use the PSA test for older folks are pretty valid, IMO.

My HMO policy states they will pay for it up to the age of 75.

*raises an eyebrow*

So I checked into it, as no insurer in this area has such a policy. I take it you are covered by Kaiser-Permanente. Interestingly, they will pay for screening up to 80 if you've never had one before, and their site was typically vague if you are in a higher risk category. They indicated that they won't chip in for any exam over 85.

As I said, if you are in to rigid cost-containment, this kind of thing is mandatory. I'm just surprised this doesn't strike you as age discrimination, as that is exactly what it is.

No, I left Kaiser many years ago. I will check into things further, and, yes, it strikes me of age discrimination and a lot else.!!!

It is age discrimination. I would write more, but I don't wish to offend the political sensitivities of some folks.

54 and yet to do my first ...

Hadn't thought to check their site, thanks for the info!